CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Essentia Health Virginia

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$868

about 0.9× the $927 Medicare rate · typically $450–$928

modeled estimate · not a bill or quote

What this hospital charges insurers

$920

About the fair price

about $52 over the fair price · 1.0× Medicare

Medicare pays $927 Fair price $868 This hospital $920 Cash price $1,830 Hospital's list price $2,914

How we calculate the fair BaseRate →

How this hospital compares to other MN hospitals

Highest price of the 9 MN hospitals we have prices for — worth calling around.

Cheapest $118 Priciest $920

Black dot = this hospital, among the 9 MN hospitals with a price for this procedure. Full list below.

A fair price for a Upper endoscopy with biopsy is about $868 (about 0.9× the $927 Medicare rate). Essentia Health Virginia charges insurers about $920, or about $1,830 in cash — about the fair price. Located in Virginia, MN.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$920 - $2,564	99%
Blue Cross Blue Shieldmajor	$920 - $2,477	99%
Aetnamajor	$2,477	267%
Cignamajor	$2,626 - $2,634	283%
HealthPartners	$920 - $2,634	99%
Medica	$670 - $2,124	72%
Sanford Health Plan	$1,250 - $1,660	135%
Security Health Plan	$920 - $2,244	99%
UCare	$920 - $1,917	99%
+ 12 smaller / regional plans	$874 - $2,244

Government programs also on file: Medicare.

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,830), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 43239.

Insurance Before you use insurance

Call your insurance company to confirm Essentia Health Virginia is in-network.
Ask your insurer whether prior approval is required for CPT code 43239.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Essentia Health Virginia

Compare: Upper endoscopy with biopsy at other MN hospitals

Insurance negotiated median for the same procedure, sorted lowest first.